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Staff Software Engineer, Distributed Systems

Ambience Healthcare· Engineering
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San Francisco$226k - $283kFull-timePosted 8mo ago

About the role

Ambience seeks a Staff Software Engineer to own core distributed infrastructure (database architecture, caching, multi-tenancy, latency and reliability) enabling scalable, low-latency real-time clinical workflows across healthcare settings.

Responsibilities

  • Database Architecture & Scaling — Own database performance end-to-end: query optimization, indexing strategy, connection management, capacity planning. Design multi-tenant data patterns that maintain performance while balancing isolation tradeoffs.
  • Caching & Latency Optimization — Build caching infrastructure that keeps EHR API latency out of critical user paths. Identify and optimize hot paths across the application. Build instrumentation to catch performance regressions before they reach users.
  • Rate Limiting — Design systems that respect EHR API rate limits while maintaining user experience. Build infrastructure that degrades gracefully under load: queue management, circuit breakers, load shedding.
  • Reliability & Observability — Dashboards and alerting for database performance, cache hit rates, connection pool utilization, API latency by customer. Systematically identify and harden against failure modes: connection exhaustion, cache stampedes, thundering herds.

Qualifications

  • 7+ years in software engineering, 3+ focused on infrastructure, backend systems, or platform engineering
  • Staff-level scope: owned cross-cutting infrastructure, debugged production issues that stumped others
  • Strong backend fundamentals in Python, Go, TypeScript, or similar
  • Deep experience with relational databases (Postgres preferred)
  • Comfort reading code across the stack to trace performance issues
  • Track record of diagnosing and solving scaling or reliability problems
  • In SF, 3x/week in-person

Skills

Required:Database optimizationMulti-tenant data patternsCaching systemsReliability & ObservabilityPython/Go/TypeScript

Benefits

  • Comprehensive medical, dental, and vision coverage for you and your dependents
  • 401(k) with a company match of up to 3% of base salary
  • A remote-friendly culture (with a San Francisco HQ) and full equipment provisioning
  • Parental leave
  • Annual company-wide off-sites, team off-sites and regular team lunches and all-hands gatherings, with travel, lodging and meals covered
  • Flexible time off with no annual cap, company-wide holidays and an annual holiday shutdown from December 24–January 1
Last updated Oct 14, 2026. Interested? Apply on the company site.

About Ambience Healthcare

The AI Platform Clinicians Choose for Documentation and Coding

The AI Platform Clinicians Choose for Documentation and Coding

AI PlatformDocumentationCodingHealthcareHealth System
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